One of the key issues facing society in this millennium is what to do with the genetic information we uncover.

Germane to the genome

Lecturer to discuss dilemmas posed by genetic information

By Deane Morrison

Published on February 24, 2005

A young man stands accused of a violent act. In his defense, he
claims he was abused as a child and that he has a genetic condition
that research has strongly linked to a predisposition to violence,
especially when coupled with childhood abuse. What's a jury--and
society--to do?

This is the kind of dilemma we all face as advances in genome
research allow us to sort people according to their probable future
health and behavior. Ellen Wright Clayton, a professor at
Vanderbilt University, will tackle these issues at 11:30 a.m.
Friday, February 25, in a talk, "Over-Reading the Human Genome: The
Threat to Privacy, Employment, Group Identity, and Responsibility,"
in the Mississippi Room of Coffman Union on the Twin Cities
campus.

Contrary to the nightmare world of the movie
"Gattaca," in which genetic tests were used as absolute arbiters of
people's employment opportunities, a clear genetic profile can have
messy implications. Society has a choice about how to deal with
genetic information, and there's no getting around it.

The young man mentioned above is not entirely hypothetical. Some
people are born with low levels of an enzyme known as MAO-A, and
evidence suggests that this condition predisposes one to violence.
Children with low MAO-A levels, if abused, have worse outcomes as
adults than others, said Clayton in an interview.

"So, if children [with low MAO-A] are abused, are you quicker to
take them out of the house?" she said. "If levels are high, do you
leave them alone?"

The point is that while genetic science can reveal a person's
predilections, it is value-neutral. It does nothing to help society
decide what to do with the information. Courts, legislative bodies,
and workers on the ground still have to grapple with hard
decisions.

Questions like the one about the violent offender are parallel
to questions about workplace discrimination, said Clayton.

"For example, you can predict that having women in the workplace
will be costly because of child bearing," she said. "But we've
decided that's a cost society has to bear. We've enacted the Family
and Medical Leave Act, which shows that the vision of the [public]
good is complicated."

She also raises the issue of the Americans with Disabilities
Act, or ADA. It required employers to hire people with disabilities
if they could do the work with reasonable accommodations, she
said.

"But under Bush, the executive branch added that future health
care costs could be taken into account," Clayton explained. She
cited a Supreme Court case involving a man with hepatitis C, a
liver disease, who had worked around refineries and was applying
for maintenance work with Chevron, for which he was well qualified.
In the case, which was decided in 2002, the court upheld a
regulation by the Equal Employment Opportunity Commission, which
allowed companies to refuse to hire a person who would "pose a
direct threat to the health or safety of other individuals" or to
himself or herself, according to the Center for an Accessible
Society's Web site. Chevron claimed the man would suffer further
liver damage from working at maintenance jobs around a
refinery.

"Chevron didn't want to hire him because his medicines and
medical leaves would cost too much," said Clayton. "It's
unfortunate the Supreme Court eviscerated ADA [by this case]."

Contrary to the nightmare world of the movie Gattaca,
in which genetic tests were used as absolute arbiters of people's
employment opportunities, a clear genetic profile can have messy
implications. Society has a choice about how to deal with genetic
information, and there's no getting around it.

"Despite messages about genetic determinism, we do have input in
how to deal with it," she said. "I believe we have a responsibility
to say, once we find genetic variation, what do we do?"

In her talk, Clayton will also address efforts to determine race
through genomics. There is no genetic variance in the population
that correlates one-on-one with race, but, she said, some forensic
groups have claimed they can detect race through DNA tests. Clayton
will discuss current activity in genome research and forensics,
cognizant of the dangers in declaring a perpetrator belongs to a
certain race based on shaky DNA evidence. Certain genetic patterns
may be more frequent in certain races, but the correlation is
statistical, not absolute, she said.

"The strategy I suggest is to be really clear about getting the
science right," said Clayton.

Clayton is the Rosalind E. Franklin Professor and director of
the Center for Genetics and Health Policy, professor of pediatrics,
and professor of law at Vanderbilt. Her talk is the Deinard
Memorial Lecture on Law and Medicine, and it is sponsored by the
University's Joint Degree Program in Law, Health, and the Life
Sciences and the Center for Bioethics.